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This study aimed to determine the mediating roles of perceived control and resilience in the association between mutuality and quality of life (QoL) in caregivers of adults with heart failure.
A multi-centre cross-sectional study.
We recruited 268 patient-caregiver dyads with heart failure using convenience sample enrolled from four hospitals in Henan Province, China from March to December 2023. Caregivers' mutuality, perceived control, resilience and QoL were assessed. A multiple-mediation model was tested using the PROCESS macro in SPSS.
Caregivers' mental QoL positively correlated with mutuality, perceived control, and resilience. Caregivers' physical QoL was correlated with mutuality. Conversely, perceived control and resilience showed no significant correlation with physical QoL. Moreover, the association between mutuality and mental QoL was mediated by perceived control and resilience, respectively, and together in series, accounting for 32.3%, 14.1% and 28.2% of the total effect, respectively.
Perceived control and resilience mediated the link between mutuality and mental QoL in caregivers of adults with heart failure. Interventions targeted at strengthening perceived control and resilience may improve caregivers' mental QoL. Additionally, the mental QoL may be improved by indirectly enhancing mutuality among caregivers of adults with heart failure.
It is important to develop multimodal intervention strategies that combine perceived control and resilience to amplify the positive impact of mutuality on the mental QoL of caregivers in individuals with heart failure.
The STROBE guideline was adopted to report this study.
No patient or public contribution.
To compare and analyse the differences in the clinical reasoning competence of nurses with different working years and their relationship with self-directed learning competence.
A cross-sectional survey design (online investigation) was used. A total of 376 nurses were recruited from four independent hospitals in China. Online questionnaires collected data on nurses' demographic characteristics and assessed their clinical reasoning and self-directed learning competence. Pearson correlation analysis, t-test, analysis of variance (ANOVA) and multivariate regression analysis were used.
Clinical reasoning competence scores of nurses with working years >10 years were higher than those of other nurses. Self-directed learning competence scores of nurses with working years of <1 year and (from ≥1 year to <3 years) were lower than those of nurses with working years of 6–10 years and >10 years. Self-directed learning competence scores of nurses with working years of 3–5 years were lower than those of nurses with working years of >10 years. There was a positive correlation between clinical reasoning competence, self-directed learning competence and each dimension among nurses of different working years. There are differences in the influence of different dimensions of self-directed learning competence on clinical reasoning competence among different working years.
There were differences in clinical reasoning and self-directed learning competence among nurses with different working years. Self-directed learning competence is a positive predictor of nurses' clinical reasoning competence, which applied to nurses with all working years; however, the specific effect of self-directed learning competence on clinical reasoning competence differed among nurses with different working years.
Nursing managers should pay attention to the development characteristics of clinical reasoning competence and self-directed learning competence of nurses with different working years and determine effective intervention strategies according to specific influencing factors.
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